Technical Standards for Nursing Education Programs in the 21st Century

Perception of Tunisian Medical Students with Chronic Conditions: Pilot Study

Background

Medical studies are hard to manage especially for students with specific needs. These students warrant some adaptations in studies and trainings in order to achieve learning goals. Studies showed they face structural and cultural barriers and stigma. Current efforts aim to encourage integration of these persons in order to increase diversity.

Objective

This study aimed to assess perception of Tunisian medical students with specific needs.

Method

Cross-sectional study through online questionnaire including learners affiliated to the Faculty of Medicine of Tunis (students, interns, and residents) who consider they have specific needs. This questionnaire was elaborated by authors and explored barriers faced by participants, needed help, and suggested solutions. Study respected consent and confidentiality.

Results

This study included 40 participants. Most of them (n = 32) were post-graduate (interns and residents). The most reported condition was mental disability (n = 14). Main challenges faced by participants were work time schedule, unhealthy lifestyle, and negative attitudes from peers and supervisors, and 19 felt victim of stigma. Reported specific needs were adapting work schedule and psychological support from peers, from supervisors, or from mental health professionals. Almost half of the participants did never disclose their difficulties (n = 21). Suggested solutions involved to have a counseling center within the faculty. Only 8 participants knew there was a new unit helping students with specific needs in FMT.

Conclusions

Despite efforts of the university, medical learners with chronic conditions still face many structural and cultural barriers to inclusion. Most participants suggested to have more psychological support from faculty.

Nursing Faculty Perceptions Regarding Students With Physical Disabilities

BACKGROUND

Students with physical disabilities continue to face barriers seeking entry into nursing programs even as the nursing profession advocates vigorously for the rights of these individuals.

PURPOSE

The purpose of this study was to identify faculty perceptions that create barriers for students with physical disabilities to meet the requirements of a BSN education.

METHODS

Nursing faculty (n = 111) completed an online survey about the ability of a student who uses a wheelchair for mobility to meet required outcomes.

RESULTS

Participants believed students could meet the 14 cognitive and affective domain outcomes (88%-100%) for generalist practice. Their agreement that students could meet psychomotor domain outcomes was lower (66%-90%). Younger faculty expressed more positive perceptions.

CONCLUSIONS

Using the psychomotor requirements of bedside nursing as the technical standard for nursing education is a barrier for students with physical disabilities. Faculty should expand their perceptions of the essentials of nursing education to create an inclusive environment.

Beyond Technical Standards: A Competency-Based Framework for Access and Inclusion in Medical Education

Efforts to include people with disability as students and practitioners in the health professions have gained momentum in recent years. However, prevailing technical standards at U.S. medical schools have biases that can prevent or impede their admission, promotion, and graduation. These standards derive from an approach first promulgated in 1979 and have since remained largely unaltered. Current technical standards at most medical schools are now at odds with changes occurring since the 1990 enactment of broad civil rights protections for people with disability and current aspirations for diversity, equity, and inclusion in the medical profession. It is time to replace the technical standards construct with an approach more consistent with current medical practices, and with societal imperatives of equity and social justice. Such an approach should assess candidates' demonstrable skills and merits, rather than relying on a preconceived construct identifying the presence or absence of defined levels of ability. The maturation of competency-based approaches to curricular design and assessment provides an opportunity to reconceptualize the abilities required to practice medicine, foster the appropriate inclusion of physicians with disability, and better align medical education and training with broader societal needs and goals.